SKIATOOK, Okla. -- Municipal trustees amended a town ordinance Monday night to reflect a change in protocol for Skiatook Emergency Medical Services. Before an estimated crowd of 70 people, the Board of Trustees voted 4-0 to approve the measure, which enlarges the area of nonemergency service to a 15-mile radius from 10. Skiatook's Fire Department-based Emergency Medical Services adopted the change in December 2009, Fire Chief Dale Parrish said. The ordinance merely ratifies that change in procedure.

"We changed our protocol to ... 15 miles so we could at least include a hospital," he said Monday.

Owasso, about 13 miles away, has two hospitals: St. John Owasso and Bailey Medical Center. With no hospitals within the former nonemergency service area, patients were often being taken to Tulsa hospitals.

"It was not being efficient to take nonemergency calls that distance (to Tulsa), and Owasso can serve that need," Parrish said.

Shortly after taking the chief's job in January 2009, Parrish discovered that 50 to 60 times per month, the city's two ambulances were both gone at the same time, leaving the town to rely on mutual-aid from cities such as Owasso, Collinsville and Hominy for ambulance calls. Parrish calculated that it takes 78 to 97 minutes for nonemergency trips to and from Tulsa, where the closest hospital is about 22 miles from Skiatook.

"The types of calls that were nonemergency were eating us alive," he said. Parrish said life-threatening Priority 1 and Priority 2 patients, such as stroke and heart patients and those injured in high-speed vehicle collisions, are still directed to stroke, heart and trauma centers in Tulsa. "Stroke-related, ... you're going to St. John (Medical Center) Tulsa," Parrish said. "It is a stroke center. You may want to go to St. Francis (Hospital) because that's where your doctor is. But if you've called me for a stroke and ... are actually having stroke-like symptoms, you're going to St. John Tulsa. That's the protocol. That's where we go."

The change has been unpopular with some residents. Beth Ray said that in May 2010, her husband, Jerry Ray, had a stroke and spent three days in Bailey Medical Center. Two days after being released, he began having similar symptoms -- confusion and slurred speech.

Although she wanted him to go to St. John in Tulsa, the ambulance delivered him to St. John Owasso, which ended up sending him to Tulsa, anyway, she said. She added that when she had a transient ischemic attack, or mini-stroke, last April, her husband drove her to St. John Medical Center.

"I'm doing fine," she said before the meeting. "But I'm finding more and more people here who are packing their loved ones into a car and taking them to Tulsa."

Dr. Victor Waters, a physician in Skiatook, spoke up several times before Brown ordered him removed from the meeting by Police Chief John Lawrence.

"Is it more important to have turnaround time or better care of the patient?" Waters asked trustees.

Outside after the meeting, he said the problem in Skiatook is not money but standard of care.

"There are four areas where they are not meeting it," he said. "No. 1, they are sending strokes to Owasso when even Owasso sends them to Tulsa. No. 2, they are sending heart attacks to Owasso when Owasso sends them to Tulsa. No. 3, the patients who have multiple medical problems - dialysis, cancer, whatever -- when they get sick, they are sending them to Owasso rather than the Tulsa hospital where they are treated. Major trauma is also going to Owasso, which is a Level IV trauma center, rather than to Tulsa, where they have Level II."